Implementation of ERAS Protocols: In Theory and Practice

Area of Science:

• Perioperative Medicine
• Implementation Science
• Healthcare Management

Background:

• Enhanced Recovery After Surgery (ERAS) pathways aim to improve patient recovery and reduce hospital stays post-major surgery.
• Successful ERAS implementation depends on multidisciplinary teams, organizational commitment, and robust audit systems.
• Common barriers include resistance to change, resource limitations, and interdepartmental communication challenges.

Purpose of the Study:

• To analyze the theoretical and practical implementation of ERAS pathways within the Turkish healthcare context.
• To identify challenges and opportunities for ERAS adoption in Turkey, particularly given the lack of an ERAS-qualified center.

Main Methods:

• Review of existing literature on ERAS implementation strategies and barriers.
• Analysis of theoretical frameworks within implementation science to understand change processes (top-down vs. bottom-up).
• Contextualization of findings within the specific healthcare environment of Turkey.

Main Results:

• Despite evidence-based ERAS guidelines, global implementation remains limited due to systemic challenges.
• Implementation science offers methodologies to address care gaps and support practice change.
• Understanding national policies, organizational factors, and cultural context is crucial for successful implementation.

Conclusions:

• Effective ERAS implementation requires addressing identified barriers through strategic planning and resource allocation.
• Further research is needed to develop and test tailored implementation strategies for ERAS in Turkey.
• Bridging the gap between ERAS evidence and practice is essential for optimizing surgical patient outcomes.